ENTtoday: August 2010

Departments

In the wake of this year’s landmark health care reform legislation, one of the most hotly debated topics comes courtesy of the Dartmouth Atlas of Health Care, as politicians, analysts, researchers and physicians grapple over how to resolve the contentious issue of geographical disparities in health care spending.

A physician who was recently offered a lucrative position with an otolaryngology practice in his community asked me to review his current employment agreement to determine if it contained any prohibitions against accepting the job. His previous employment contract contained a noncompetition clause that, justifiably, caused him and his prospective employer some concern. As it turned out, in his case, and in many others, the noncompetition clause was not as restrictive as it appeared at first glance. The provision was penetrable and my client joined the new practice with a clear conscience that he was not in violation of his previous contract.

With the availability of noninvasive procedures that use injectable fillers to do the work surgery once monopolized, more people than ever before are seeking the elixir of youth that comes now at the end of a needle rather than a knife.

Otolaryngologists are likely to see some changes in the way informed consent is handled at the hospitals where they perform surgery. Recent changes from the Centers for Medicare and Medicaid Services (CMS), along with Joint Commission rules, have prompted many hospitals and health systems to get more involved in what previously fell firmly in the physician’s purview.

With pediatric otolaryngology continuing to evolve, the American Society of Pediatric Otolaryngology (ASPO) is exploring subcertification in the field, saying it is specialized enough that it deserves recognition. The society has approached the American Board of Otolaryngology (ABOto) about the possibility and is working on defining the knowledge base that would be required for a physician to become subcertified as a pediatric otolaryngologist.

Other

What is the impact of surgery on the sleep and sexual function of patients with chronic rhinosinusitis (CRS)? Background: Recent evaluations of the effects of CRS on the quality of life (QoL) have shown that CRS has a significant QoL impact even in comparison with chronic debilitating diseases such as diabetes and congestive heart failure. Recent […]

What is the efficacy and safety of bioabsorbable miniplates as an alternative to autologous grafts in single-stage laryngotracheal reconstruction for subglottic stenosis? Background: Since the 1960s, the incidence of acquired subglottic stenosis has dramatically increased due to the improved survival of low birth weight infants and the increased use of long-term endotracheal intubation in neonates. The […]

What are the current racial/ethnic and socioeconomic disparities in the prevalence of frequent ear infections (FEI) among children in the U.S.? Background: There has been an increase in the prevalence of otitis media reported in the U.S. in the 1980s and 1990s. An understanding of the size and distribution of the population of children with FEI […]

What is the independent effect of human papillomavirus (HPV) on oropharyngeal cancer survival? Background: HPV has been associated with oropharyngeal cancer risk and appears to underlie the rising incidence of this disease in the U.S. and Europe. HPV-positive oropharyngeal cancers may be associated with a better prognosis than HPV-negative oropharyngeal cancers. Study design: Retrospective analysis of HPV […]

Can localized papillary thyroid cancer (PTC) forgo surgery and be observed? Background: Recent epidemiologic trends have documented a dramatic increase in the incidence of PTC, much of it due to the overdiagnosis of subclinical PTC. In 2006, the authors published a landmark study demonstrating this increase and raised the question of whether the definition or treatment […]